The growing need for nurses has dominated health care conversations for more than a decade. Today, the deficit discussion has expanded into primary care doctors. While current doctors and patients are already feeling the pain of the physician shortage, with longer work hours and office wait times, the problem is going to get progressively worse if we don’t find a solution soon.
Several factors play into the primary care shortage, from fewer medical students choosing this area of health care to an aging population demanding more medical services. And, while doing more to recruit new physicians seems like a logical solution, it won’t close the primary care gap anytime soon. After all, it can take up to 12 years to prepare a student for primary care practice.
There are, however, viable solutions that can help take some of the pressure off of physicians. We call them nurse practitioners (NPs), and studies show these advanced practice nurses can manage up to 90 percent of the care provided by primary care physicians.
To paint a picture of the current primary care landscape, the Association of American Medical College released a study in March 2015 that anticipates a shortage of 12,500 to 31,100 primary care physicians by 2025. Another study released by the Health Resources and Services Administration projects a shortage of 20,400 primary care physicians in 2020. Interestingly enough, most shortage projections don’t factor in the possibility of nurse practitioners taking on an expanded primary care role, according to the Institute of Medicine.
Quality Alternative
Created in 1965, the nurse practitioner role combines nursing and medical services to care for individuals, families, and groups. Nurse practitioners diagnose and manage acute and chronic conditions in patients as well as emphasize health promotion and disease prevention. They practice autonomously and in collaboration with other health care professionals to manage the needs of patients.
To be a nurse practitioner, you must have a graduate-level nursing degree, specialty certification, and the required licensure. According to the paper “Nurse Practitioners in Primary Care” published by the American Association of Nurse Practitioners, almost all NPs are prepared in a primary care focus (e.g., adult, family, or pediatrics). But no matter the focus, primary care nurse practitioners are primed to serve in diverse settings.
Another paper published by the American Association of Nurse Practitioners titled “Nurse Practitioner Cost-Effectiveness” references an extensive case analysis that found nurse practitioners provide equivalent or better medical care at a lower cost than physicians. The analysis also showed that nurse practitioners in a physician practice potentially decrease the cost of patient visits by as much as one third, particularly when seeing patients in an independent, rather than complementary, manner.
Despite the mounting body of evidence that shows nurse practitioners can increase patient care capacity without adding extra physicians to a primary care practice, most states fail to utilize NPs to the full extent of their education and training. If we want a strong primary care sector, there needs to be less bureaucracy and more states maximizing the value of nurse practitioners.
Scope of Practice
Currently, there are 22 states that allow nurse practitioners to practice to the full extent. While the Institute of Medicine and National Council of State Boards of Nursing recommends the full practice model, the country’s remaining 28 states either restrict or reduce how nurse practitioners can serve in their profession. You can view the licensure and regulatory requirements for each state at aanp.org.
- Full NP Practice: Full ability to evaluate and diagnose patients, order and interpret diagnostic tests, initiate and manage treatments under the exclusive licensure authority of a state board of nursing.
- Reduced NP Practice: Lessened ability to engage in at least one element of practice. Regulated collaborative agreement with an outside health discipline required to provide patient care.
- Restricted NP Practice: Limited ability to engage in at least one element of NP practice. Supervision, delegation, or team-management by an outside health discipline required to provide patient care.
Future Projections
Approximately 60,400 nurse practitioners were practicing in primary care settings in 2012. The Health Resources and Services Administration projects the supply of primary care nurse practitioners to increase by 30 percent between 2010 and 2020. If effectively integrated into our health care system, nurse practitioners, along with physician assistants, could potentially reduce the expected shortage of primary care providers in 2020 by about two-thirds.
Advanced Education
Given the physician shortage and the push for nurse practitioners to play a stronger role in primary care, it’s a great time to consider a career as a nurse practitioner. It’s also worth mentioning that nurse practitioners have one of the highest salaries in nursing.
At Marquette University, we offer several education paths that pave the way for you to become a nurse practitioner. Among these paths is our part-time Acute Care Nurse Practitioner (ACNP) program in Indianapolis, Indiana, and our Direct Entry Master of Science in Nursing program in Pleasant Prairie, Wisconsin.
If you are a working registered nurse with a BSN, our ACNP program allows you to pursue a master’s degree without putting your career on hold. Taking less than three years to complete, the part-time program focuses on the older adult population. Its accredited curriculum blends online learning and onsite instruction at St. Vincent in Indianapolis, Indiana.
While not a direct path into a nurse practitioner role, our Direct Entry MSN program makes it possible to earn a master’s degree in nursing in as few as 18 months. The program leverages your non-nursing bachelor’s degree and combines a rigorous, fast-paced blend of online and onsite curriculum. Upon completion of the program, you can pursue nurse practitioner certification in adult acute care, adult primary care, pediatric acute care, or pediatric primary care.
If you want to be part of the physician shortage solution, while advancing your career at the same time, contact our admissions team to learn more about our advanced nursing degree programs.
Sources:
- kff.org/medicaid/issue-brief/tapping-nurse-practitioners-to-meet-rising-demand-for-primary-care
- www.aanp.org/images/documents/practice/NP_Patient_Outcomes_Toolkit.pdf
- www.aanp.org/images/documents/publications/costeffectiveness.pdf
- www.aanp.org/images/documents/publications/primarycare.pdf